Across the Wide Zambezi: A Doctor's Life in Africa (28 page)

At four o' clock in the small hours, a
telephone rang in the room next to the one I shared with Gareth, boring through
the thin wall like a dentist's drill, waking both of us. It stopped. A woman's
angry voice bawled: 'Get lost!'

A few seconds later, the telephone rang
in our room. Gareth wearily picked it up and a piping little voice asked: 'Are
you ready to go fishing, Uncle Gareth?'

I had not been long at Umvuma before I
received a visit from David Taylor, the physician at Gwelo. He told me it was
his custom to visit the district hospitals once a month, something which became
a regular policy later, but was then a matter of individual enthusiasm. And
very welcome such visits are, and very helpful and instructive: just as
important as the DMO's visits to the rural stations. And one day, he arrived in
the nick of time.

I had a middle-aged female patient who
had been puzzling me. For a week she had had general pains and a low-grade
fever (blood smear was negative for malaria), and now she was developing
weakness in the legs. Already she was confined to bed. Just as we entered the
ward on David's monthly visit, she stopped breathing.

Quick as a flash, David diagnosed
Guillain-Barré syndrome: ascending paralysis of unknown origin, probably
infectious - the first time I had heard of it. I have seen several cases since,
and have been able to take pre-emptive action in time, thanks to David's most
opportune visit: otherwise, I would have had a very mysterious death on my
hands and would probably have called it polio.

We had no mechanical respirator in the
hospital. We wheeled the patient quickly to theatre, me pumping her midriff on
the way, got her onto the table and a tube down her windpipe, connecting it to
the Boyle's anaesthetic machine, which, of course, can deliver oxygen. Then we
loaded patient and machine onto the ambulance and drove the fifty miles to
Gwelo with me sitting in the back, pumping the bag. At the hospital, they got
her connected to a Manley machine, and I left.

Next day, I heard on the telephone that
she had already recovered respiration and was off the machine. The paralysis
disappears in reverse order to its onset, from the head downwards. She left
hospital fully recovered, a month later.

I was on the bowling green one Saturday
afternoon when a car stopped in the road beyond the hedge. Two young white men
got out and then helped a friend, whom they brought up to the hedge in a
four-handed lift. There were calls for the doctor, so I went over to have a
look.

I recognised Jan van der Merwe, a young local
farmer, who had fallen off his horse, playing polocrosse, and had an injured
ankle. They had removed his riding boot and the ankle was very swollen.

I scribbled some instructions to the
nurses at the hospital on a cigarette packet - morphine, X-ray - and asked his
friends to take Jannie down there, telling them I would follow shortly. Then,
like Sir Francis, I went on with the game.

When I got to the hospital, I found
Jannie, more comfortable after his morphine, sitting on the X-ray table. I
studied the plates, looking hard at the malleoli - the knobs of the ankle,
where most fractures occur - and could see no fracture. (The degree of swelling
and pain in an obviously stoical patient should have made me more suspicious.)
I diagnosed a sprained ankle. I thought Jannie might be more comfortable in a
plaster, so ordered one.

On Sunday evening I was in the bar of
the Falcon when Jannie's wife came in. Jannie was in great pain and wanted the
plaster off. I scribbled another note to the people at the hospital, asking
them to remove it and replace it with a crepe bandage.

Next morning Jannie telephoned the
hospital, still complaining of pain. June received the call, and believing
(with the rest of the town by now) that he had only a sprained ankle, was less
sympathetic than she might have been otherwise. She asked Jannie to send his
wife up to the hospital for more Panadols.

Not surprisingly, Jannie's wife did not
appear, and next Saturday evening, I was surprised to see Jannie in the club on
crutches with his leg in a fresh plaster. He was telling his friends (who by
then did not include me) all about it. He had been, he said, to see a 'decent
doctor'. To my concerned inquiries, he informed me that after June's (innocent)
rebuff, he had got his wife to take him to my colleague, the DMO at Enkeldoorn,
thirty miles away. I gathered that the doctor there had taken more X-rays and
(to my selfish relief) had seen no fracture either, but having the advantage of
the previous history, had sent him to a specialist in Salisbury. The
specialist, according to Jannie, had said he had a fracture which might need a
screw.

At the earliest opportunity on Monday
morning, I got out Jannie's X-rays again and, with the help of Crawford Adams,
re-examined them very carefully. Finally, I discerned that two of the bones in
that Rubik's cube of the upper foot, whose names nobody remembers after medical
school, were really one, divided by a line which looked less smooth than the
articulating faces of the other bones. I was seeing the first (and last)
fracture of the talus (the bone which forms the tenon to the mortise of the
ankle) I was to see in forty years of practice. And instead of happening to
some uncomplaining black African, it had to happen to the unforgiving white
African, Jannie van der Merwe.

A few days later, David Taylor came out
on his monthly visit. Over a cup of tea I told him the story (I had to unburden
to some colleague), and, before I got to the solution, tested him with the
X-rays (which was probably an unfair thing to do to a member of the Royal
College of Physicians - whose specialty is not bones). To the satisfaction of
my ego, he also failed to recognise the fracture.

By now, Jannie was going about the
district blackening my name to all who would listen. Not everyone approved of
this attitude, including his own wife; but being conscience-stricken and
feeling sorry for him, I sat down one night and wrote him a letter. (This was
not as mad a proceeding as it might have been in a more litigious country than
Rhodesia.) I explained that I had taken another look at the X-rays and could
now see the fracture, which was a very uncommon fracture, and apologised for
any lack of sympathy I may have shown when under the impression that he had
simply sustained a badly sprained ankle.

I received no reply to this, or any
verbal acknowledgement. In the event, Jannie did not need an operation and made
as good a recovery as he would have made in any case. But he never had a civil
word for me after that.

At a place like Umvuma in those days,
there was only one government doctor, who was on call all the time, day and
night, week in, week out, for years on end. He could only escape by leaving the
station - a long way behind. Then emergencies would be sent to the next
suitable place - usually the next district, where one's colleague would also
stand in for weeks or months while his neighbour went on leave, and vice versa.
In the case of Umvuma the matter was simpler, and emergencies were sent to the
provincial hospital at Gwelo, a mere fifty miles away.

Otherwise they called me by telephone or
they sent the ambulance out for me, if I went fishing say. Sometimes I would
play bowls at Enkeldoorn. I would tell them to telephone me there, knowing that
they would never drag the doc off the bowling green on a Saturday afternoon for
anything less than a caesar or a major road traffic accident (RTA).

I was fishing at a river pool once, a
little distance from my friends, and started pulling bream out like rabbits
from a conjuror's hat. After I had about half a dozen, I was about to call my
friends to share the lucky strike, when a black face appeared through the reeds
and the ambulance driver said they wanted me at the hospital. I packed up, fish
and all, and followed him in my own car. I found a woman with a ruptured uterus
- labouring out in the bush too long, perhaps, with an old caesarean scar (I
forget) - and performed my second subtotal hysterectomy. 'Another life saved,'
as Howell in Birkenhead used to say, to the fury of the theatre sister (both of
them Welsh), every time he did a circumcision.

One night there was a sing-song at the
Falcon. Somebody brought a guitar, and I was one of the strummers. The old
Southern African favourites were bawled out over the cups:
Sarie Marais,
Come a Rookie, Marching to Pretoria
- there was nothing effete about
Rhodesian singing; in those days, at any rate.

Billy Campbell and Phil von Lilienfeld
(yes, another Umvuma aristocrat) left early - ie, about midnight - in Billy's
pick-up. Soon a report was brought that they had been involved in a road
accident.

The two young cops (whose departure
usually signalled closing time, giving the rest of us plenty of scope), who had
a remarkable gift for sobering up at a moment's notice, took off. The ambulance
went out, and I went to the hospital to prepare for casualties.

They had hit an African bus, almost
head-on, knocking off its outer wheel and sending the bus plunging into the
ditch, with no one hurt. Billy had been killed on the spot. John Holland, the
owner of the Falcon, remarked philosophically: 'He knows it all now.'

Billy's truck was crumpled up. Phil had
a fractured ankle. He had, of course, provided his own anaesthetic. I put a
plaster on it and sent him off to Gwelo: I was not up to screwing ankles at
that stage.

In the early hours one morning, a young
African man, a teacher, crashed his car into a train at the Fairfield crossing
and was killed instantly. His brother came to the hospital to identify the
body. I met him outside the little mortuary.

The brother was a fellow doctor, Dr
Mazarodze, who later became a minister of health in the post-independence
government, before his own untimely death after only a few months in office.

I had made sure the face was washed and
the body covered with a blanket. I simply said to my colleague: 'I am very
sorry.' I led him into the mortuary. The attendant lifted the blanket from the
face. Dr Mazarodze sobbed: 'O, my God! Stephen!'

I put my arm round his shoulders and
gripped him firmly until he had recovered himself.  Then I led him outside. I
asked him if he would like a cup of tea. He said quietly, 'No, thank you,' and
left.

After a week I received a letter from
him. 'Thank you for your kind sympathy on the sad occasion of my brother's
death.'

My touch had not gone unnoticed.

A medical student came to stay with me.
He was a friend of one of the policemen and still in second year. This was
earlier than usual for an attachment, which comes in the clinical years ahead.
But Graham was very keen, and I have always had a bit of the schoolmaster in
me, so I was glad to have him and his company.

While at my house he became addicted to
a certain drug. It did not affect his studies, as he shortly after passed his
second MB, gaining gold medals in every subject: he was the brightest student in
his year, and many other years too.

The certain drug was Russian literature.

He was a reader. He was a pale dark lad
and, unlike most Rhodesians, not interested in sport. But he had never met
Russian literature before, of which I had a fair collection.

He devoured
War and Peace
in
three weeks,
The Brothers Karamazov
in a fortnight.  Then he started on
Chekhov.

He read the Russians morning, noon and
night. He took them to the toilet. He sat at the side of the bowling green and
read them when I dragged him off to the club. In the Falcon he sat with
Raskolnikoff in the taverns of St Petersburg while the darts flew over his
head.

Trying to vary his literary diet, I
offered him Dickens and Hardy. He gave them ten minutes each, before silently
replacing them on the shelf and taking down another Russian.

While at Umvuma, I attended the annual
bush doctors' refresher course at Bulawayo, where I met 'Jock' Scott for the
first time: a man who was to play a big part in my life later. He was then DMO
at Belingwe.

In spite of his sobriquet, which like
Mav's was used by all his friends, including his wife, Jock was a Londoner. He
was then about sixty: a tall, swarthy man whose remaining hair sprouted rather
wildly from the sides of his head. Altogether, he looked as much like a gipsy
fiddler as a doctor.

The musical appearance was not inapt.
Jock had a teacher's certificate from the Royal College of Music, and played
both violin and piano. He had considered a musical career but decided, in his
own words, 'he would rather be a second-rate doctor than a fourth-rate
musician'.

We had some chat about music. I took an
instant liking to him and was glad, as the narrative will show, to find him my
neighbour some years later.

The circumspect DMO at Enkeldoorn was
succeeded by an Australian, Dr Sadd, who was rather less so. Unfortunately, the
poor man was rarely sober: only, in fact, in the morning, before the pub
opened, when his work was impaired by his hang-over. He did not last long, and
was dismissed the service after a few months.